I have
been hearing a lot of pundits and politicians bemoan "socialized
medicine" and its supposed inefficiencies and inequities. These horror
stories are never accompanied by data, just hearsay and anecdotes from
"a friend of a friend" in Canada or the United Kingdom. Rarely have I
heard from people who have themselves experienced a universal public
health care system. As one of those people, I thought I should speak up.
While living in Finland for three years, I experienced socialized medicine up close and personal. I gave birth to my son there.
Finland's
public health care system is run by a government agency called KELA,
and the doctors, nurses, dentists, and other health care workers are
government employees. KELA usually covers 100% of the cost of most
services at public clinics, with small copayments for prescriptions and
hospital stays that are scaled to a patient's income. Finland also has
many private clinics that are available to those who want to use them,
where patients pay the extra cost of the private service (KELA will pay
up to what the service would cost at a public clinic). When you visit a
clinic or hospital you present your KELA card at the reception desk,
and if a payment is necessary you can pay at the clinic, or a bill can
be sent to your home.
All
Finnish citizens and permanent residents are eligible for KELA
benefits, as are immigrants on work and political asylum visas. I was
eligible for the KELA system because I was in Finland on a work visa,
and I paid income and social services taxes from my paychecks. Yes the
taxes were high, about 40% of my gross pay. However, it is comparable
to my take-home pay here in the US once I factor in my health insurance
premiums, deductibles, and copayments, along with my income and social
security taxes.
The care
that I received in Finland throughout my pregnancy and childbirth, and
for the first 9 months of my son's life, was simply amazing. I saw the
same nurse and doctor for monthly pregnancy checks (and later they were
my son's primary medical caregivers); their offices were in the same
hallway. Both women knew us by name and by sight, and always remembered
what we had discussed for the previous visit. Routine ultrasounds were
performed at the maternity hospital; my nurse made each appointment for
me and I simply showed up at the hospital for the procedure. When my
labor started I headed to the maternity hospital, and the hospital's
nurses and doctors knew exactly who I was, as my medical files were
available to them through KELA's computerized filing system. (Patients
must sign a form that allows their medical files to be accessible by
other medical facilities, so a patient's privacy rights are protected.)
Every nurse coming on duty reviewed my file before seeing me, and so my
discussions with them were focused on what my son and I needed at the
moment, not what had been done during the previous shifts. After my
emergency Cesarean operation and a four day stay in the hospital, only
one bill was waiting for us when we got home, for a total of 260 Euros.
I never
had to wait to see a medical professional, nor was any necessary
procedure delayed or denied. Every nurse and doctor I saw was caring
and knowledgeable, and spent whatever time was necessary to make sure
that I received the care I needed.
I have
now been living and working back in the US for 6 months, and already I
have had problems with my health insurance plan through my employer. I
found out the hard way (that is, at the doctor's office after my son's
vaccination visit) that my son had been arbitrarily dropped from my
plan months before, even though I had been paying the premiums for the
family plan all along. It took almost a week of phone calls to get him
reinstated. All the while, I privately wondered if the two ear
infections he had had in the spring had prompted some computer at the
health insurance company to calculate that he was "overusing" the
system, and automatically drop his coverage.
That may
seem like paranoid thinking, but I have seen it all before. In 2001, my
mother was diagnosed with aggressive breast cancer. Instead of focusing
her strength and attention on recovering from a double mastectomy,
chemotherapy, and radiation, she spent much of her time arguing with
the health insurance company and the hospital over bills she had
already paid, and routine treatments that should have been covered by
her insurance plan. Ultimately she lost her insurance altogether when
she lost her job, and she has since been living in remission, uninsured.
When
these pundits and politicians go onto national television and spew all
sorts of false rhetoric about the evils of socialized medicine, it
makes my blood boil. They are doing an incredible disservice to their
fellow Americans, both those with and without health insurance. For
every anecdote they have about a Canadian waiting six months for
necessary open heart surgery, I can find twenty Americans for whom that
equally necessary surgery is completely out of reach. Now is the time
for an honest assessment about what (if anything) can be salvaged from
our current system, and to put a system in place that does what it is
supposed to do: provide health care.